۱- Introduction

۲- Methods

۳- Results

۴- Discussion

References

Abstract

Backgrounds: Depression in children and adolescents is usually underrecognized. Epidemiology of depressive symptoms in primary school students is inconsistent across studies. This study reports a systematic review and metaanalysis on the prevalence of depressive symptoms in primary school students in China. Methods: Literature search was performed in both international (PubMed, PsycINFO, EMBASE) and Chinese (China National Knowledge Internet, WANFANG Data and Chinese Biological Medical Literature) databases. The random-effects model was used to analyze data. Results: Twenty-seven studies involving 42,374 subjects were included. The pooled prevalence of depressive symptoms in Chinese primary school students was 17.2% (95% CI: 14.3%-20.5%). Subgroup analyses found that the prevalence significantly varied between geographic regions, with western China reporting the highest prevalence. Meta-regression analyses found that year of survey and study quality were significantly associated with the prevalence of depressive symptoms. Conclusions: Given the high prevalence of depressive symptoms and its negative health outcomes, preventive measures, regular screening and effective treatments need to be implemented for this population.

Introduction

Depression is the most common mental health problem among children and adolescents and is also one of the top ten causes of disability among teenagers globally (Global Burden of Disease 2015 Disease and Injury Incidence and Prevalence Collaborators, 2016). Depression in childhood and adolescence is associated with impaired psychosocial functions (Ayuso-Mateos et al., 2010; Judd and Akiskal, 2000) and increased risk of future depression in adulthood (Hankin et al., 1998; Naicker et al., 2013; Rutter et al., 2006). Depression could exist in a continuum of severity, ranging from depressive symptoms, minor depression to major depressive disorder (MDD) (Angst et al., 2000; Judd and Akiskal, 2000). Similar to clinically diagnosed depression, depressive symptoms also have negative health impacts among children and adolescents, such as social problems (Verboom et al., 2014), poor academic performance (Verboom et al., 2014), substance use (Earnshaw et al., 2017), obesity (Johnson et al., 2018) and impaired cognitive functions (Calvete et al., 2013; Cole et al., 2011).